Ketamine: An Option for Migraine and Depression?

James1 November 2016

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Yes, with cautions.

It’s been a while since we talked about ketamine for migraine (see Watch for it – Ketamine for Migraine and More), but the NMDA (N-methyl-D-aspartate) receptor antagonist is still gaining ground as a possible treatment for migraine and depression.

Known on the street as a date rape and club drug (one especially easy to overdose on), ketamine is actually an anaesthesia medicine that has also been used for chronic pain conditions and depression.

Compared to illegal use and aesthetic use, the dosages are quite low, and usually done in conjunction with other treatments under close doctor supervision. But it could be a real help to people who have a combination of symptoms/diseases (such as migraine and depression) or those who have not responded well to other common treatments.

Ketamine was discussed in two separate sessions of the American Academy of Pain Management 2016 annual meeting. Dr. Duren Michael Ready, a headache specialist at Baylor, Scott & White Health in Texas, reported on research supporting the use of a 10-50mg dose given by nasal spray to migraine patients. This dosage seemed to reduce migraine aura, and at the higher level (50mg) treat depression that hasn’t responded to other treatments.

Dr. Ready emphasized that it’s important to use alongside preventative measures, so that it will be used as little as possible.

Dr. Ben Keizer, also in Texas, spoke on the use of ketamine for complex regional pain syndrome (CRPS) and post-traumatic stress disorder (PTSD). In these cases, the treatment can also combat headache, which is one of the possible symptoms. It may be that ketamine could help with other comorbid conditions such as fibromyalgia and IBS.

Although the doses are not high enough to sedate patients, some do experience hallucinations or an “out of body” experience, even though the dosages are low.

With caution and at lower doses, ketamine is being used to help certain migraine and headache patients. Have you been prescribed ketamine? What was your experience?